Sep 17, 2008

Mismanaged Healthcare

Situation: My doctor says I need surgery and that right soon. Scheduled for the 30th.
Situation: Hub's employee insurance plan is underwritten by his Company.
Situation: Health management company basically works for the employer.
Result: Conflict of Interest
Surprising Phone Call today: Insurance company's doctor/screener refuses to pay for the surgery.
Primary reaction: tears, tears, hysterical sobs, tears...
Action: talk to a Dogberry of a nurse with insurance company who evades plain speech. Scream and cry with her for 2 hours over the course of 3 different calls.
Conclusion the First: appeal.
Secondary reaction from Doctor's Office: "that's effin' unheard of!!!"

It shouldn't take 2 hours to get to a simple point of: our screening doctor denies your need. You and your doctor can appeal this. Meanwhile, it took a month to get me scheduled for the end of this month. All that seems to have gone out the window.

I was so shook, I came home from work. Upon arrival here I find a letter stating that the imaging radiologist wants to smash my poor boobs one more time (after taking 2 tries a month ago) and wave a magic ultrasound over them.

I told him to go fuck himself, my girls are fine. [Mighty fine! -The Jolly Roger]

"Other than that, how was the play, Mrs. Lincoln?"

Can nationalized healthcare be any worse? If "self-insured" businesses handle it so cleverly, how much more a government beancounter who decides I'm too much of a liability? Hello AIG?

In the spirit of Dogette's cathartic, "Fuck Oprah" posts, allow me my own moment here.

Gimme a sec...




FUCK YOU, insurance companies!!!

Feel free to append this post with your own "moment."


pamibe said...

Well, that sucks the big one. To put it mildly.

No wish to pry, but I hope you are okay or will be that way upon completion of the surgery.

julie said...

Well, shit.

I don't have a moment to share, though I did realize this past month that it was far simpler to get my dog in and out of surgery than it would possibly have been for a human.

Hang in there, Joan - lots and lots of prayers heading your way.

Ted said...

Hang in there kiddo! Good wishes coming your way.

LauraB said...

Jesu! Madness. And it will need the talk of an atty type with "endangering her life with the delays in her care" language, I am sure.

As for the repeat smasheroo - yeah. And a nice hefty bonus for the end of FY? Pass. OR the ultrasound ONLY. Even then, you will have to pay for it unless they code it just right.

Lady and Lord protect you, m'dear, while those f*ckers figure out what liability means.

Deep breath...rub ear...wah suuuu....

GUYK said...

DAMN! That sounds about like the gotdam HMO we used to have...hope it all works out..let me know, huh?

Anonymous said...

The screening doctors name and address? :~|

dogette said...

I hope you're OK. The FUCK YOU sounded good even from over here.

Jean said...

Well, shit.
Since I've been taking my meds, I haven't beat up anyone. But, I will gladly make an exception for you.

I hope they get this straightened out soonest. Let me know if there is anything I can do.

QP said...

I'm so sorry you're having to deal with idiots when your well-being is at stake. Take good care of yourself.


LauraB said...

Um...I think that was supposed to be woo-sahhh...

I hate it when I do that.


Michelle said...

It is bad enough that we have to deal with the stress of surgery, recovery, missed work, and missed life experiences, then they pull crap like this, I hear you. Remember, the squeaky wheel always gets the grease!

Wait until you get to the hospital for the "pre" visit.... which is to say "We accept cash, checks, and cards and we need your 20% today".... I wrote the check and cried the whole way home.

My thoughts are with you!

John said...

And people think it'll get BETTER with socialized medicine? This is seriously wrong. Keeping you in my thoughts and prayers.

mushroom said...

You're in my prayers, Joan.

With all due respect to the accountants out there, I hate accountants. They are worthless parasitic bloodsuckers who give tapeworms, ticks, and horseflies a bad name.

The only reason accountants aren't as bad as lawyers is that they are too damn dumb to pass the bar.

... with all due respect.

PeggyU said...

Joan: I do hope everything works out ok!!! Dealing with insurance is almost worse than being ill in the first place.

As to: "Can socialized medicine be any worse than this?" YES. The problem actually IS socialized medicine. Since the time of FDR (and especially during the Johnson administration)government influence on and involvement in the medical and insurance industries has led to what is already a largely socialized system. The government imposes mandates on businesses to provide insurance for their employees. And for those who don't receive employee benefits, the government is ready to "help".

What we have is not a failure of capitalism, but the predictable failure of socialism. Whenever the government inserts itself, the bureaucracy, paperwork, and expense goes up, and the efficiency and quality drop.

USS Ben USN (Ret) said...

What happened to the good ol' days when you could trade eggs and slab of bacon for a surgery or somethin' like that?

Sal said...

Prayers for you.
The eldest daughter packed up her family and her enormous 8 months pregnant self and moved 1000 miles away to help her mother-in-law with her husband's dad, who had ALS.
Her old OB in AZ informed her, on her second visit, that they didn't take her insurance any longer.
So, she was out searching for a new one six weeks before the baby arrived.
Happy ending- she found a good one and MJ arrived safely. Hope yours will turn out as well.